Region A RAC Reposts Four Issues for Maryland

DSC Healthcare has translated four issues originally posted as all patient refined diagnosis-related groups (APR-DRGs) to Medicare severity diagnosis-related groups (MS-DRGs). The issues affect Maryland inpatient hospitals, the Region A recovery audit contractor (RAC) said on its website.

The RAC said using MS-DRGs will be “more beneficial and less impactful to providers” because Maryland hospital billing departments submit claims through the CMS Grouper using MS-DRGs. It also will make responding to additional documentation requests (ADRs), result letters and demand letters easier if the RAC uses the same MS-DRGs that the Medicare administrative contractor used, the RAC said.

Maryland hospitals that had received ADRs with APR-DRGs will receive updated letters with the MS-DRGs, the RAC said. DSC Healthcare said it had sent ADRs only for medical necessity review of APR 203 (chest pain) and APR-DRGs associated with MS-DRG 313 (chest pain).The issues are below.